“The Dose Makes the Poison” ~ Paracelsus.

November 25, 2014

An interesting thing happened when I ate a “strictly clean” diet: My once strong digestion weakened. For a period of time I had no wheat, gluten, dairy, flours, white rice or potatoes, sugars (except fruit), or artificial sweeteners. I ate a ton of vegetables, whole grains, root vegetables, organic (and often local) meat, poultry, and fish, and seasonal fruit. These weren’t extreme changes for me, but a more restrictive way of how I normally eat. The trend was slow and gradual, but negative, and it progressed in severity. Strange, right?

With fall came a new season of food choices. There was a marked increase in my intake of winter squashes, cauliflower, broccoli, apples, pears, and Brussels sprouts. It was insidious, but sure enough something further did not agree. My symptoms became concerning, but I figured I had to be able to fix them since these symptoms were not present just several months prior.

So began an era of trial and error and close observation. As I often recommend to my patients, I put on my “detective glasses” and went to work. I was finally able to narrow the culprit down to a few possibilities, and one day it was evident. The food that tore up my insides and made for uncomfortable symptoms: apples. Wait, what?

Had my restrictive diet altered the diversity of my gut bacteria in such a way leaving me susceptible to a fructose sensitivity? Did I over-consume apples, pears, and other high FODMAP foods with the change of seasons?

After three days of no apples, all my symptoms were fully gone. After a few weeks I did have an apple. But just 1, and waited a week or so before I had another one. No symptoms. I’ve since had a few apples, but not daily, and no symptoms reported.

According to Traditional Chinese Medicine (TCM) theory, when we over-consume concentrated sugars (fruit included), over-consume difficult to digest, cloying, and fried/greasy/fatty foods, and/or over-consume cold, raw foods, the spleen’s function of transforming and transporting qi is impaired, digestion is weakened, less nutrients are absorbed, and ensuing dampness may occur. One may also have a genetic predisposition for a weak digestive system, making them more sensitive and vulnerable to dietary irritants. In addition, it is possible that a restrictive diet may also cause internal stress and imbalance. Both Matt Stone and Joey Lott write a lot about this topic.

In TCM, honey and rock sugar are 2 examples of medicinal foods. Their sweet flavor helps to tonify the qi of the spleen and stomach, digestive organs. It’s known that too much sugar will damage the spleen (this idea is similar to the impairment of insulin function with overconsumption of sugar in type 2 diabetes). So if too much is bad, is none best? Could too little also be harmful to the digestive process?

Personally, I feel best with 1-2 tablespoons of maple syrup and some dark chocolate on most days. I feel awful with too much, but some sugar feels better than none. Water is another good example. Some is better than none, but more is not necessarily better than some! Matt Stone writes very well about the dangers of overhydrating which correlate nicely to the TCM idea of injured spleen and kidney yang function, resulting in “water buildup.”

I DO recognize scenarios that would benefit from a healing period of abstinence. Regulating blood sugar, healing from digestive troubles, regulating hormones may all require a temporary break from certain foods or an emphasis on eating in certain ways. But long-term abstinence/restriction can lead to nutrient deficiency, an imbalanced microbiome, and a restricted and uncomfortable way of living. In my personal and clinical experience, long-term restriction isn’t necessarily required to keep the benefits of short-term restriction and may do more harm than good.

I mean, we’d all agree that apples are considered to be on the healthy side of the food spectrum, right? And historically I have thrived while eating apples, so it must follow that I can – and likely should – eat them, just not too many! It’ll be up to me to determine that threshold.

I encourage my patients to play “detective” and look at their symptoms objectively. Why spend time and money getting endoscopies, colonoscopies, blood work, taking strong medications with potential negative side effects if we can make simple lifestyle observations and changes?

An apple a day keeps the doctor away, but more isn’t necessarily better!

5/5/15 UPDATE: I have been enjoying ~1 apple/day for a few months, and my digestion is as great and strong as ever. When apples are in season this fall, I will be sure to stick to “an apple a day,” but not more 🙂